Impact on time to active antimicrobial therapy with 24-hour pharmacist review of Accelerate Pheno BC Kit results

Kinn, Patrick; Ford, Bradley; Percival, Kelly M; İnce, Dilek

doi:10.1017/ash.2022.274

Cited by 1 publication

(1 citation statement)

References 10 publications

(15 reference statements)

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“…The implementation of our antimicrobial scoring system also had no effect on time to effective antibiotic therapy. Kinn et al 7 showed that 24-hour pharmacist review of rapid diagnostic blood culture results decreased the incidence of patients receiving ineffective therapy, which our study did not find. However, in our study 74.5% of patients were receiving effective therapy at the time the culture resulted, limiting the possibility of pharmacist intervention.…”

Section: Discussionsupporting

confidence: 92%

Evaluation of an Automated, Pharmacist-Driven, Antimicrobial Patient Acuity Scoring System for Hospitalized Bacteremic Patients

Karpen,

Murphy,

Reed

et al. 2023

Hosp Pharm

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Purpose: The implementation of an automated, pharmacist-driven, scoring system within the EMR has been shown to improve patient care in patients with Staphylococcus aureus bacteremia by increasing the adherence to disease specific quality-of-care measures. However, there are a lack of studies evaluating the incorporation of blood culture review into standard, non-antimicrobial stewardship pharmacist workflow. Our institution implemented an automated, pharmacist-driven, antimicrobial scoring system in the electronic medical record (EMR) on August 6, 2019. Methods: This was a retrospective, single-center, quasi-experimental study of hospitalized, non-critically ill adult (18-89 years of age) patients with bacteremia between July 6, 2018 and July 5, 2019 (pre-implementation group) and September 6, 2019 and September 5, 2020 (post-implementation group). The primary outcome was time to directed antibiotic therapy in patients with positive blood cultures. Secondary outcomes included hospital length-of-stay, days of therapy (DOT) while inpatient, time to effective therapy, 30-day all-cause mortality, and rates of Clostridioides difficile infections documented within 3 months of positive culture results. Results: Implementation of the antimicrobial scoring system did not result in a significant change in time to directed antibiotic therapy (32.5 hours vs 37.4 hours; P = .757). There was also no difference found for time to effective antibiotic therapy (−12.6 hours vs −14.2 hours; P =.905) and no difference found for all other secondary outcomes. Conclusion: The implementation of the antimicrobial scoring system did not lead to an improvement in clinical outcomes. Further research is needed to better define a patient population that may benefit from this system.

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Section: Discussionsupporting

confidence: 92%